Τετάρτη, 25 Απριλίου 2018

Initiation and slow propagation of epileptiform activity from ventral to dorsal medial entorhinal cortex is constrained by an inhibitory gradient

The Journal of Physiology, EarlyView.


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Genioglossus reflex responses to negative upper airway pressure are altered in people with tetraplegia and obstructive sleep apnoea

The Journal of Physiology, EarlyView.


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History‐dependence of muscle slack length following contraction and stretch in the human vastus lateralis

The Journal of Physiology, EarlyView.


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Humanizing the mouse immune system to study splanchnic organ inflammation

The Journal of Physiology, EarlyView.


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Saving the brain one heartbeat at a time

The Journal of Physiology, EarlyView.


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Aberrant cortical excitability reflects the loss of hand dexterity in musician's dystonia

The Journal of Physiology, EarlyView.


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Enterocyte K+ ion permeability and fluid secretion: missing the correct channel or missing the point?

The Journal of Physiology, EarlyView.


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Uteroplacental insufficiency temporally exacerbates salt‐induced hypertension associated with a reduced natriuretic response in male rat offspring

The Journal of Physiology, EarlyView.


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Mutations in the voltage‐sensing domain affect the alternative ion permeation pathway in the TRPM3 channel

The Journal of Physiology, EarlyView.


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Efficacy of single‐incision laparoscopic totally extraperitoneal repair for irreducible or incarcerated inguinal hernia

Asian Journal of Endoscopic Surgery, EarlyView.


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Comparison of Carba NP-Direct, Carbapenem Inactivation Method, and β-CARBA Tests for Detection of Carbapenemase Production in Enterobacteriaceae

Microbial Drug Resistance, Ahead of Print.


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Multiple Arginine Residues Are Methylated in Drosophila Mre11 and Required for Survival Following Ionizing Radiation

Mre11 is a key player for DNA double strand break repair. Previous studies have shown that mammalian Mre11 is methylated at multiple arginines in its C-terminal Glycine-Arginine-Rich motif (GAR) by protein arginine methyltransferase PRMT1. Here, we found that the Drosophila Mre11 is methylated at arginines 559, 563, 565, and 569 in the GAR motif by DART1, the Drosophila homolog of PRMT1. Mre11 interacts with DART1 in S2 cells, and this interaction does not require the GAR motif. Arginines methylated Mre11 localizes exclusively in the nucleus as soluble nuclear protein or chromatin-binding protein. To study the in vivo functions of methylation, we generated the single Arg-Ala and all Arginines mutated flies. We found these mutants were sensitive to ionizing radiation. Furthermore, Arg-Ala mutated flies had no irradiation induced G2/M checkpoint defect in wing disc and eye disc. Thus, we provided evidence that arginines in Drosophila Mre11 are methylated by DART1 methytransferase and flies loss of arginine methylation are sensitive to irradiation.



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Metaboreceptor activation in heart failure with reduced ejection fraction: Linking cardiac and peripheral vascular haemodynamics

Experimental Physiology, EarlyView.


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Nerve growth factor‐dependent hyperexcitability of capsaicin‐sensitive bladder afferent neurones in mice with spinal cord injury

Experimental Physiology, EarlyView.


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Seroimmunity to Hepatitis B Virus in Children With Inflammatory Bowel Disease: Effects of Booster Vaccination

No abstract available

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2017 NASPGHAN Distinguished Service Award

imageNo abstract available

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Safety of Appetite Manipulation in Children with Feeding Disorders Admitted to an Inpatient Feeding Program

imageObjective: Appetite manipulation can be effective in weaning children off gastrostomy tube feeding dependence but can cause dehydration, hypoglycaemia, and ketone body production, which is anorexigenic. As the safety of this approach has not been described, our aim was to describe adverse events observed when weaning children from G-tube dependence using our appetite manipulation protocol. Methods: This was a retrospective study of prospectively collected data of patients who completed our inpatient tube-weaning protocol. Daily safety parameters included twice-daily urine specific gravities and urine ketones and fasting capillary blood glucose. Graded clinical interventions to manage adverse events were collected. Results: A total of 143 children with a mean age of 4.8 ± 2.4 years were seen in the inpatient feeding program of which 74 (51.7%) were male. The children were hospitalized 10.1 ± 2.5 days with the vast majority being discharged between days 11 and 14. Overall, 78.2% of patients experienced at least 1 adverse event: urine specific gravity >1.020 was seen in 60.5%, ketonuria in 48.9%, and hypoglycemia (≤60 mg/dL) in 13.4%. Only 2 children had blood glucose levels

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2017 AAP Murray Davidson Award

imageNo abstract available

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Bone Mineral Density of Very Long-term Survivors After Childhood Liver Transplantation

imageObjectives: Liver transplant patients are at risk of osteopenia and fractures but limited information is available in long-term survivors after childhood transplantation. This study aimed to assess bone mineral density (BMD) of very long-term, >5 years, survivors after liver transplantation in childhood. Methods: Patients aged 5 years after transplant were potentially eligible but only those with ongoing review in our state were included. Dual-energy x-ray absorptiometry (DXA) was used to measure BMD. Patients aged

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Induced Pluripotent Stem Cell-Derived Hepatocytes and Precision Medicine in Human Liver Disease

imageLiver-like human cells can be generated from human skin by converting fibroblasts to "induced pluripotent stem cells" (iPSCs), then differentiating the iPSCs into "induced hepatocytes". Although still primarily used as a research tool, emerging applications involving iPSC-derived induced hepatocytes have exciting and provocative clinical and translational potential. This review provides a brief summary of the current status of this field and obstacles that must be overcome before this novel tool will enable precision medicine-based approaches to human liver disease.

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Vitamin B1 Deficiency Related to Excessive Soft Drink Consumption in Japan

imageThe aim of this study was to clarify the picture of vitamin B1 deficiency (VB1D) caused by excessive soft drink consumption in Japan. A nationwide survey of children with soft drink-induced VB1D was conducted using a structured research form. Patient information was obtained from 2 sources: training hospitals for board-certified pediatricians and those identified by a database search. We obtained data from 33 children. Twenty-one children had a nonnurturing home environment. The median duration of excessive soft drink intake was 3.5 months and the daily intake was 1000 mL or more in 25 children. Infection was the most common reason for excessive soft drink consumption. Only 4 children had the classical triad of Wernicke encephalopathy. One child died, and 12 had neurological sequelae. A majority of children with soft drink-induced VB1D did not have a nurturing home environment. It is imperative to establish measures to prevent future cases of VB1D.

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Clear Liquid Versus Low-fibre Diet in Bowel Cleansing for Colonoscopy in Children: A Randomized Trial

imageObjectives: In light of a paucity of data on the role of diet in colonoscopy preparation in paediatric population, the present study was designed to compare the effectiveness of clear liquid and low-fibre diets for breakfast and lunch on the day preceding colonoscopy in children. Methods: This prospective, randomised trial was conducted at the Department of Paediatric Gastroenterology and Nutrition in Warsaw, Poland. Eligible patients, referred for colonoscopies, were 6 to 18 years old. Patients were randomly divided into 2 groups: the first received a clear liquid diet and the second a low-fibre diet on the day before colonoscopy. In the afternoon, all participants were asked to drink polyethylene glycol with electrolytes at a dose of 66 mL/kg to a maximum of 4 L. The effectiveness of bowel cleansing was measured using the Boston Bowel Preparation Scale (BBPS). The preparation tolerance was assessed by parents and children using a visual analogue scale. Adverse effects were reported. Results: In total, 184 patients were enrolled. Of those, 96 received the clear liquid diet and 88—the low-fibre diet. The mean age of both groups was 15 years. There were no differences between the 2 study groups in age, weight, and sex, as well as in total BBPS score (BBPS ≥ 5 96.6% vs 95.1%, P = 0.5). The frequency of adverse effects was similar in both groups; nausea was the most common (P = 0.8). Conclusions: Clear liquid and low-fibre diets administered to children the day before colonoscopy demonstrated similar bowel cleansing effectiveness.

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The 2017 Shwachman Award

imageNo abstract available

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Randomized Controlled Clinical Trial on Value of Domperidone in Functional Abdominal Pain in Children

imageObjectives: The aim of the study was to evaluate the therapeutic effect of domperidone on children with abdominal pain predominant functional gastrointestinal disorders (AP-FGIDs). Methods: One hundred children (aged 5–12 years) fulfilling Rome III criteria for AP-FGIDs were randomized into 8 weeks of domperidone or placebo treatment. Primary outcomes defined were cure and patient-reported general improvement. Secondary outcomes were reduction in the severity of abdominal pain and increase in gastric motility. Patients were followed up for 6 months. Results: Eighty-nine (42 in placebo group, 47 in domperidone group) completed the trial at 8 weeks. Seventy-nine completed the 6-month follow-up. When primary outcomes were assessed at 8 weeks, 37 (74%) in the domperidone group and 25 (50%) in the placebo group showed patient-reported general improvement (P = 0.013), whereas no significant difference was observed in cure (22 [44%] vs 14 [28%] P = 0.09). At 6-month follow-up 30 (60%) in the domperidone group and 19 (38%) in the placebo group reported cure (P = 0.028), whereas 44 (88%) in the domperidone group and 33 (66%) in the placebo group showed patient-reported general improvement (P = 0.009). When assessing secondary outcomes at 8 weeks, the domperidone group reported significant reduction in the severity of abdominal pain (54.1% vs 24.7%, P  = 0.008) and an increase in the antral motility index (27.5% vs 7.2%, P = 0.029). None of the patients reported intervention-related adverse effects. Conclusions: Domperidone may be a safe and effective therapeutic modality to achieve a lasting remission of symptoms in children with AP-FGIDs.

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Trends of Cholecystectomies for Presumed Biliary Dyskinesia in Children in the United States

imageBackground: Biliary dyskinesia (BD) is a controversial clinical entity. Standardized diagnostic test and management guidelines are lacking in children. Published data suggest that long-term outcomes of surgical and medical management are similar. We sought to determine national population-based trends of cholecystectomies performed in children for BD and associated healthcare expenditure in the United States during a 10-year period. Methods: Using Nationwide Inpatient Sample and the International Classification of Diseases, the 9th revision clinical modification codes, we identified children who had a cholecystectomy for BD from 2002 to 2011 in the United States. Results: A total of 66,380 cholecystectomies were identified as primary procedural diagnosis using weighted analysis from 2002 to 2011 in children. BD was the primary indication for cholecystectomy in 6674 (10.8%) of the patients. During the study period, the number of cholecystectomies performed for BD in children increased from 6.6% in 2002 to 10.6% in 2011, and a majority were adolescent white females. The annual health care expenditure for surgical management of BD for children in the US was estimated to almost $16 million/year. Conclusions: Despite lack of standardized diagnostic criteria and variable outcomes of surgical intervention reported in pediatric literature, cholecystectomies are commonly performed for children with BD in the United States. Consensus guidelines for the diagnosis and management of this controversial disorder in children are needed.

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Awareness and Implementation of the 2014 ESPGHAN/NASPGHAN Guideline for Childhood Functional Constipation

imageObjective: The aim of the study was to assess whether physicians approach children with functional constipation according to the 2014 European Society of Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN)/North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) guideline. Methods: We invited pediatricians and pediatric gastroenterologists in the Netherlands and the United States to participate in this anonymous survey using a self-developed questionnaire containing 19 multiple choice questions concerning evaluation and treatment of children with constipation. Results: We included 328 physicians (67% from the United States, 34% from the Netherlands). The majority of US responders (53%) worked in primary care, whereas all Dutch responders worked in a hospital. In total, 31% of responders were not familiar with the guideline (38% US responders vs 16% Dutch responders, P 

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Hydrolyzed Formula With Reduced Protein Content Supports Adequate Growth: A Randomized Controlled Noninferiority Trial

imageObjective: A high protein content of nonhydrolyzed infant formula exceeding metabolic requirements can induce rapid weight gain and obesity. Hydrolyzed formula with too low protein (LP) content may result in inadequate growth. The aim of this study was to investigate noninferiority of partial and extensively hydrolyzed formulas (pHF, eHF) with lower hydrolyzed protein content than conventionally, regularly used formulas, with or without synbiotics for normal growth of healthy term infants. Methods: In an European multi-center, parallel, prospective, controlled, double-blind trial, 402 formula-fed infants were randomly assigned to four groups: LP-formulas (1.9 g protein/100 kcal) as pHF with or without synbiotics, LP-eHF formula with synbiotics, or regular protein eHF (2.3 g protein/100 kcal). One hundred and one breast-fed infants served as observational reference group. As primary endpoint, noninferiority of daily weight gain during the first 4 months of life was investigated comparing the LP-group to a regular protein eHF group. Results: A comparison of daily weight gain in infants receiving LPpHF (2.15 g/day CI −0.18 to inf.) with infants receiving regular protein eHF showed noninferior weight gain (−3.5 g/day margin; per protocol [PP] population). Noninferiority was also confirmed for the other tested LP formulas. Likewise, analysis of metabolic parameters and plasma amino acid concentrations demonstrated a safe and balanced nutritional composition. Energetic efficiency for growth (weight) was slightly higher in LPeHF and synbiotics compared with LPpHF and synbiotics. Conclusions: All tested hydrolyzed LP formulas allowed normal weight gain without being inferior to regular protein eHF in the first 4 months of life. This trial was registered at clinicaltrials.gov, NCT01143233.

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Family Health-related Quality of Life in Pediatric Cyclic Vomiting Syndrome

imageObjective: The aim of the study was to evaluate the relationship of disease characteristics and child anxiety symptoms to family health-related quality of life (FHRQoL) in youth with cyclic vomiting syndrome (CVS). Methods: Forty-two parents of youth ages 8 to 18 years diagnosed with CVS completed the Family Impact Module of the PedsQL, a measure of the impact of the child's illness on the family. We evaluated the relationship of disease characteristics and child and parent proxy reports of anxiety symptoms on the Screen for Childhood Anxiety and Related Emotional Disorders to FHRQoL. Results: Parent report of child anxiety symptoms and missed school days (mean = 11.93, standard deviation = 14.62) were the strongest predictors of FHRQoL (r2 = 0.33, df = 1.39, F = 8.51, P = 0.006). Other disease characteristics, including frequency, duration, chronicity of CVS episodes, and delay in initial CVS diagnosis were not significantly associated with the FHRQoL total score. Child anxiety symptoms by either parent and/or child report were associated with subscales of the FHRQoL, including family physical functioning, family communication, and family daily activities. Conclusions: HRQoL for the families assessed in this study was associated with anxiety symptoms to a greater extent than disease characteristics, indexing the importance of a biopsychosocial approach to CVS management. Screening for anxiety symptoms and support for school absences due to illness are indicated to help lessen the impact of CVS on the family as a whole.

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Esophageal Squamous Cell Papillomatosis Arising in Focal Dermal Hypoplasia in a 3-Year-Old Girl

imageNo abstract available

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Trends of Magnet Ingestion in Children, an Ironic Attraction

imageBackground and Objectives: Ingestion of rare earth magnets is a serious ongoing hazard for pediatric patients. Our study aims to investigate whether 2012 Consumer Product Safety Commission (CPSC) policy action, in coordination with efforts from consumer and physician advocacy groups, decreased the incidence of magnet ingestions in children in the United States since 2012. Methods: Data from the National Electronic Injury Surveillance System (NEISS) was used to evaluate trends in emergency department (ED) encounters with pediatric patients (

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Should Giant Cell Hepatitis With Autoimmune Haemolythic Anaemia Be Considered a Paediatric Autoimmune Liver Disease?

No abstract available

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Choice of Endoscopic Procedure in Children With Clinically Suspected Gastrointestinal Graft-versus-host Disease

imageObjectives: Gastrointestinal graft-versus-host disease (GI-GVHD) is a potentially life-threatening complication after hematopoietic stem cell transplantation. Symptoms indicating GI-GVHD motivates endoscopy with biopsy sampling and histopathological confirmation. Optimal extent of endoscopy in children is, however, presently unknown. Therefore, we aimed to evaluate whether biopsies from the rectosigmoid area versus the rest of the colon/ileocolon with or without biopsies from simultaneous upper endoscopy, were equally reliable for detection of GI-GVHD and relevant differential diagnoses. Methods: Retrospective multicenter study based on histopathological re-evaluation of biopsies and hospital record data, collected from children with suspected GI-GVHD. Results: Forty-four children with 51 endoscopic occasions (81 procedures) were included. Thirty-nine of 51 (76.5%) were diagnosed as GI-GVHD, 14 (27.4%) received a differential diagnosis and 7 (13.7%) had normal histology findings. Comorbidity, that is, simultaneous detection of a differential diagnosis and GI-GVHD, was observed in 9 (23.1%) cases. Cytomegalovirus infection was the most frequent differential diagnosis, 6 of 7 were detected in biopsies from rectosigmoid and esophagogastroduodenal areas. Sensitivity for detection of GI-GVHD in biopsies collected from rectosigmoid-ileocolonic-, rectosigmoid-, or esophagogastroduodenal areas were 97.4%, 84.6%, 83.3%, respectively, and 97.4% when the latter 2 were merged. The difference, nondetected GI-GVHD in the rectosigmoid area versus detected elsewhere in the GI tract, was statistically significant (P = 0.03). Conclusions: Biopsies collected from the rectosigmoid area solely were not optimal for detection of pediatric GI-GVHD. When biopsy sampling from rectosigmoid and upper GI tract areas was combined, the sensitivity for GI-GVHD was, however, equally high as for ileocolonoscopy or full upper and lower endoscopy.

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Genetic Variants Associated With Obesity and Insulin Resistance in Hispanic Boys With Nonalcoholic Fatty Liver Disease

imageBackground and Objectives: Nonalcoholic fatty liver disease (NAFLD) disproportionately affects Hispanic boys. Further, obesity and insulin resistance are major risk factors for NAFLD. No gene localization studies had been performed on children with biopsy-proven NAFLD. This study aims to identify genomic variants associated with increased adiposity and insulin resistance in a population of children with varying histologic severity of NAFLD. Methods: We conducted a genome-wide association scan (GWAS) including 624,297 single-nucleotide polymorphisms (SNPs) distributed among all 22 autosomal chromosomes in 234 Hispanic boys (up to 18 years of age) who were consecutively recruited in a prospective cohort study in the Nonalcoholic Steatohepatitis Clinical Research Network Studies. Traits were examined quantitatively using linear regression. SNPs with P value 5% were considered potentially significant. Results: Evaluated subjects had a median age of 12.0 years, body mass index (BMI) of 31.4, and hemoglobin A1C (Hgb A1C) of 5.3. The prevalence of NAFL, borderline NASH, and definite NASH were 23%, 53%, and 22%, respectively. The GWAS identified 10 SNPs that were associated with BMI z score, 6 within chromosome 2, and 1 within CAMK1D, which has a potential role in liver gluconeogenesis. In addition, the GWAS identified 9 novel variants associated with insulin resistance: HOMA-IR (6) and HbA1c (3). Conclusions: This study of Hispanic boys with biopsy-proven NAFLD with increased risk for the metabolic syndrome revealed novel genetic variants that are associated with obesity and insulin resistance.

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High Incidence of Proteinuria in Children With Chronic Intestinal Failure Under Long-term Parenteral Nutrition

imageLong-term home parenteral nutrition (LTPN) in children with chronic intestinal failure (CIF) is associated with renal complications such as fluid and electrolyte imbalances, nephrocalcinosis, nephrolithiasis, and chronic kidney disease (CKD). The etiology of CIF-associated nephropathy is multifactorial. The aim of this study was to evaluate renal involvement under LTPN. In this study, 50 patients with CIF, median age 4.2 years (1.4–9.3; 23 girls) were included. Kidney involvement was a frequent finding in this study. CKD was present in 30% of patients without correlation with LTPN duration. Glomerular proteinuria was found in the majority of patients (76%), an important long-term risk factor for the progression of CKD. Increased urinary α-1 microglobulin was significantly associated with duration (years) of LTPN and was increased in patients with CKD.

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Clinical spectrum of KIAA2022 pathogenic variants in males: Case report of two boys with kiaa2022 pathogenic variants and review of the literature

American Journal of Medical Genetics Part A, EarlyView.


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Genetic polymorphism of sterol transporters in children with future gallstones

Gallstone disease is related to hypersecretion of cholesterol in bile, and low serum phytosterol levels. We examined how genetic polymorphisms of sterol transporters affect childhood cholesterol metabolism trait predicting adult gallstone disease.

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Inhibition of Na+/K+‐ATPase and KIR channels abolishes hypoxic hyperaemia in resting but not contracting skeletal muscle of humans

The Journal of Physiology, EarlyView.


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Gamma and infra‐slow oscillations shape neuronal firing in the rat subcortical visual system

The Journal of Physiology, EarlyView.


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Stress‐testing the brain to understand its breaking points

The Journal of Physiology, EarlyView.


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Coupling of respiration and attention via the locus coeruleus: Effects of meditation and pranayama

Psychophysiology, EarlyView.


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Only reappraisers profit from reappraisal instructions: Effects of instructed and habitual reappraisal on stress responses during interpersonal conflicts

Psychophysiology, EarlyView.


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Social influences of error monitoring in adolescent girls

Psychophysiology, EarlyView.


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Dissociation of frontal‐midline delta‐theta and posterior alpha oscillations: A mobile EEG study

Psychophysiology, EarlyView.


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A breath-holding adaptation

A breath-holding adaptation

A breath-holding adaptation, Published online: 25 April 2018; doi:10.1038/s41576-018-0014-1

A new study in Cell reports genomic selection of physiological adaptations to hypoxia in breath-hold diving marine hunter–gatherers, the indigenous Bajau people of Southeast Asia.

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Identification of 4 novel mutations of androgen receptor gene in 8 Chinese families with complete androgen insensitivity syndrome

Clinical Genetics, EarlyView.


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Single, short in‐del, and copy number variations detection in monogenic dyslipidemia using a next‐generation sequencing strategy

Clinical Genetics, EarlyView.


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NREMT launches EMS certification app

The iPhone app allows EMS personnel to manage their continuing education and recertification components

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Endostar, a Modified Endostatin Induces Vascular Normalization to Improve Chemotherapy Efficacy through Suppression of Src Signaling Pathway

Cancer Biotherapy and Radiopharmaceuticals, Ahead of Print.


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Development and Validation of RAPID: A Patient-Specific Monte Carlo Three-Dimensional Internal Dosimetry Platform

Cancer Biotherapy and Radiopharmaceuticals, Ahead of Print.


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Pecs II block for intractable postherpetic neuralgia



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Genetic characteristics of Y-chromosome short tandem repeat haplotypes from cigarette butt samples presumed to be smoked by North Korean men

Abstract

Korea has been divided into South Korea and North Korea for over 70 years. DNA profiles of the North Korean population have never been reported in the Y-chromosome STR Haplotype Reference Database (YHRD; https://yhrd.org). To investigate genetic features of Y-chromosome STR haplotypes of the North Korean population for the first time. Genomic DNA was isolated from 838 cigarette butts assumed to have been smoked by North Korean men and amplified with PowerPlex Y23 (PPY23) kit. Statistical parameters were calculated using Nei's formula and analysis of molecular variance (AMOVA). Multidimensional scaling (MDS) plot was constructed by the AMOVA tool and neighbor-joining (NJ) tree was constructed by MEGA 6.06. A total of 121 haplotypes were analyzed for PPY23 loci from a sample population. Haplotype diversity and discrimination capacity were 0.9992 and 0.9837, respectively. Genetic diversities ranged from 0.2981 to 0.9716. For the 16 Y-filer loci and eight minimal loci, respectively 90.9 and 82.6% of the matched haplotypes were estimated to belong to haplogroup O, representing the Southeast and East Asian type. The MDS plot and NJ tree indicated that the samples are most closely related to South Korean. In addition, p-value in the pairwise comparison to the South Korean was slightly above statistical significance (p = 0.0534). The Y-STR haplotypes of the samples were unique and highly genetically polymorphic. Despite the separation between North and South Korea for 70 years, they can still be considered a single genetic population, based on Y-STR haplotypes.



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RapidDeploy becomes first Computer-Aided Dispatch (CAD) System to receive ProQA Titanium Certification

Priority Dispatch recognizes RapidDeploy for its dynamic, customizable interface and commitment to the public safety community.

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A breath-holding adaptation



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Shaping neuroplasticity by using powered exoskeletons in patients with stroke: a randomized clinical trial

The use of neurorobotic devices may improve gait recovery by entraining specific brain plasticity mechanisms, which may be a key issue for successful rehabilitation using such approach. We assessed whether the...

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Comparative genomics of 151 plant-associated bacteria reveal putative mechanisms underlying specific interactions between bacteria and plant hosts

Abstract

Although much work has explored how microbes can benefit plant growth, the mechanisms underlying this intriguing process remain largely unknown, especially considering the diversity of bacteria that surrounds plants. The objective of the present study was to identify bacterial genes contributing to plant–microbe associations, beneficial effects, and host specificities. For this purpose, comparative genomics investigation of 151 plant-associated bacteria was performed. A principal component analysis of seven key genomic features revealed patterns in the specific properties of these bacteria: N2-fixing bacteria were more closely related to pathogenic ones than to beneficial bacteria. A common set of genes over-represented in these plant-associated bacteria were found to be remarkably similar in terms of (1) genetic information processing, (2) amino acid metabolism, (3) metabolism of cofactors and vitamins, (4) nucleotide metabolism, (5) human diseases, and (6) metabolism of terpenoids and polyketides. Although we did not detect a common genetic basis for these beneficial effects, further in-depth analysis revealed that each of five beneficial bacterial groups shared specific gene sets. Functional annotation showed that environmental information processing, genetic information processing and cellular processes predominated in these beneficial groups. Hypothesizing that plant-associated bacteria may have overlapping strategies to colonize their plant hosts, we successfully identified many putative genes that determine host specificities. Most of these genes were classified as transcription factors, enzymes, transporters, and chemotaxis regulators. Comparative genomics provides a powerful tool for helping to identify genes that are common among species. Genome-based views of plant-associated bacteria reveal specific interactions between bacteria and plant hosts.



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3 towns team up to keep ambulance services alive

The towns of Remsen, Steuben and Trenton are streamlining their ambulance services in an effort to keep them up and running

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Perioperative considerations for airway management and drug dosing in obese children

Purpose of review Childhood obesity, a phenomenon that is increasing globally, holds substantial relevance for pediatric anesthesia. In particular, understanding the nuances of airway management and drug dosing in obese children can be daunting. Recent findings Respiratory adverse events and challenges in managing the airway may be anticipated. In addition, drug-dosing strategies for the obese child are complex and poorly understood although recent advances have clarified the optimal dosing for anesthetics in these children. Summary Theoretical knowledge, practical skills, meticulous risk stratification and optimal drug regimens are crucial to ensure the safe conduct of anesthesia for obese children. Correspondence to Dr Jerrold Lerman, MD, FRCPC, FANZCA, Department of Anesthesiology, Oishei Children's Outpatient Center, 1001 Main St, Suite K-3502, Buffalo, NY 14203, USA. Tel: +1 716 323 6570; e-mail: Jerrold.lerman@gmail.com Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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The identification of growth, immune related genes and marker discovery through transcriptome in the yellow drum ( Nibea albiflora )

Abstract

Yellow drum (Nibea albiflora) is a commercially important marine fish, which is widely distributed in the coastal waters of China, Japan and Korea. Wild yellow drum resources have dramatically declined due to overfishing and ocean pollution. Genetic data can contribute to biodiversity conservation and protection. And molecular markers can play important roles in genetic breeding and aid in germplasm preservation in fish. In this study, 11 tissues (brain, heart, liver, kidney, muscle, head kidney, skin, fin, spleen, gonad and air bladder) were collected for pooled RNA sequencing. The unigenes were assembled using Trinity and EvidentialGene, and were then aligned to nr, nt, Swiss-Prot GO, KEGG, and KOG for annotation. Molecular markers (e.g. simple sequence repeat, SSR and single nucleotide polymorphism, SNP) were detected using MIcroSAtellite identification tool (MISA) and Genome Analysis Tool Kit (GATK). All clean reads were assembled into 109,209 transcripts, and 31,183 unigenes were generated after pruning and classifying, ranging from 201 to 19,857 bp in length (1230 bp in average), and 26,728 (85.7%) assembled unigenes had significant hits in public databases. Total of 27 and 103 unigenes were respectively identified as involved in growth- and immune-related pathways in the N. albiflora transcriptome. In addition, we identified a considerable quantity of molecular markers, including 11,484 SSRs and 56,186 SNPs. The growth- and immune-relevant genes and the molecular markers identified here provided a meaningful reference gene set and laid a foundation for future genetic selection and breeding for this species.



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3 harms of EMS miscommunication and how to fix them

Communication is critical to ensure that emergency department resources are available and ready for your patient

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Measuring Variation Across Dimensions of Integrated Care: The Maryland Medicaid Health Home Model

Abstract

Despite the proliferation of initiatives to integrate services for people with serious mental illness (SMI), measures of distinct dimensions of integration, such as spatial arrangement and care team expertise, are lacking. Such measures are needed to support organizations' assessment of progress toward integrated service delivery. We developed measures characterizing integration of behavioral, somatic, and social services to operationalize the integrated care dimensions conceived by the Agency for Healthcare Research and Quality. In a survey fielded to 46 Maryland Medicaid health homes (response rate: 96%) serving adults with SMI during 2015–2016, we found that these measures provided a useful description of variation across dimensions of integration.



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Endoscopic Electrocautery Incisional Therapy as a Treatment for Refractory Benign Pediatric Esophageal Strictures

Background and Aim: Refractory esophageal strictures are rare conditions in pediatrics, and are often due to anastomotic, congenital, or caustic strictures. Traditional treatment options include serial dilation and surgical stricture resection; endoscopic intralesional steroid injections, mitomycin C, and externally removable stents combined with dilation have had variable success rates. Although not as widely used, endoscopic electrocautery incisional therapy (EIT) has been reported as an alternative treatment for refractory strictures in a small number of adult series. The aim of the study was to evaluate the safety and efficacy of EIT in a pediatric population with refractory esophageal strictures. Methods: A retrospective chart review was conducted on all patients who underwent EIT for esophageal strictures (May 2011–September 2017) at our tertiary-care referral center. A total of 57 patients underwent EIT. Procedural success was defined as no stricture resection, appropriate diameter for age, and fewer than 7 dilations within 24 months of first EIT session. This corresponded to the 90th percentile of the observed number of dilations in the data. All patients included in the study had at least 2-year follow-up. Results: A total of 133 EIT sessions on 58 distinct anastomotic strictures were performed on 57 patients (24 girls). The youngest patient to have EIT was 3 months old and 4.8 kg. There were 36 strictures that met the criteria for refractory stricture and 22 non-refractory (NR) strictures. The median number of dilations before EIT therapy was 8 (interquartile range [IQR]: 6–10) in the refractory group and 3 (IQR: 0–3) in the NR group. In the refractory group, 61% of the patients met the criteria for treatment success. The median number of dilations within 2 years of EIT in the refractory group was 2 (IQR: 0–4). In the NR group, 100% of the patients met criteria for success. The median number of dilations within 2 years of EIT in the NR was 1 (IQR: 0–2). The overall adverse event rate was 5.3% (7/133), with 3 major (2.3%) and 4 minor events (3%). Conclusions: EIT shows promise as an adjunct treatment option for pediatric refractory esophageal strictures and may be considered before surgical resection even in severe cases. The complication rate, albeit low, is significant, and EIT should only be considered by experienced endoscopists in close consultation with surgery. Further prospective longitudinal studies are needed to validate this treatment. Address correspondence and reprint requests to Michael A. Manfredi, MD, 300 Longwood Avenue Boston, MA 02132 (e-mail: Michael.Manfredi@childrens.harvard.edu). Received 19 October, 2017 Accepted 22 March, 2018 The authors report no conflicts of interest. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Use of Infliximab Biosimilar Versus Originator in a Paediatric United Kingdom Inflammatory Bowel Disease Induction Cohort

Objectives: To summarize short-term effectiveness, safety, and cost of using infliximab biosimilar (IFX-B) drugs, (Inflectra™ and Remsima™) compared to originator infliximab (IFX-O) (Remicade®) in biologic naive pediatric inflammatory bowel disease in the United Kingdom. Methods: Prospective audit of patients starting anti-TNF therapy. Disease severity, response to treatment, and remission rate was measured by Pediatric Crohn's Disease Activity Index (PCDAI) and/or Physician Global Assessment (PGA). Results: Between March 2015 and February 2016, 278 patients (175 IFX-O, 82 IFX-B, and 21 Adalimumab) were started on anti-TNF therapy. This was compared with collected data on 398 patients started on IFX-O from 2011–15. At initiation, median PCDAI was 36 (20,48) (n = 42) in the IFX-O group and 28 (20,40) (n = 29) in the IFX-B group, (p = 0.08). Immunosuppression rates were similar: 150/175 (86%) for IFX-O and 65/82 (79%) for IFX-B (p > 0.05). Post induction, median PCDAI score was 5 (0,11) (n = 19) and 0 (0,8) (n = 15) in the IFX-O and IFX-B groups respectively (p = 0.35). There was no difference in response to treatment using PGA 85% (n = 28) in IFX-O group and 86% (n = 19) in IFX-B group (p > 0.05). Adverse events (AE) at initiation and post induction were not different between both groups (p > 0.05). Using conservative calculations, £875,000 would have been saved over a one-year period with universal adoption of biosimilars in patients who were instead treated with IFX-O. Conclusions: IFX-B is likely as effective as IFX-O in treating IBD in comparable pediatric populations. Sites should adopt infliximab biosimilar for new starts due to cost reduction with no difference in other parameters. Address correspondence and reprint requests to Professor Richard K. Russell, Consultant Paediatric Gastroenterologist, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF (e-mail: richardrussell@nhs.net). Received 16 January, 2018 Accepted 14 April, 2018 Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal's Web site (www.jpgn.org). Optional byline at editor's discretion: matched initial efficacy and safety, but with significant cost savings. Conflicts of interest RM has received consultation fees, research grants, or honorarium, from AbbVie, Janssen, Dr Falk, Tillott's pharma, 4D pharma, and Pfizer. MKHA declares that he received educational travel grants or consultation fees from Abbvie, MSD, Nutricia, and Dr Falk. JF is on the advisory board for Falk, scientific advisory board for Jansen, and has received support for travel and educational activity from Abbvie. AR has received consultation fees on advisory boards and educational/travel grants from Abbvie. SGM has received sponsorship for conferences from Abbvie. DCW has received consultancy fees from consultancy, lecture fees, and sponsorship to travel to meetings from Abbvie, consultancy fees from Takeda, and lecture fees from Falk. RKR has received consultation fees, research grants, or honorarium, from Nestlé, AbbVie, Takeda, Napp, Mead Johnson, Nutricia and Janssen. All other authors declare no conflicts of interest. © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Cutting-edge Treatment for Benign Pediatric Esophageal Strictures, a Step Forward, More to Go

No abstract available

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Worldwide variation in the dietary management of eosinophilic oesophagitis

No abstract available

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Bile Acids and the Gut Microbiome as Potential Targets for NAFLD Treatment

Semi-synthetic bile acid (BA) obeticholic acid (OCA), a potent farnesoid X receptor (FXR) agonist, exhibited beneficial effects on non-alcoholic fatty liver disease (NAFLD). However, OCA did not cause a resolution of non-alcoholic steatohepatitis (NASH). Here we discuss several prominent knowledge gaps in BA/FXR biology. Firstly, although many groups reported elevated serum BA levels, there are reports of decreased or normal serum BA levels in NAFLD, underlining the complexity of BA regulation by environmental and genetic factors. Secondly, conflicting data exist in animal studies regarding the effects of FXR signaling on obesity and associated metabolic abnormalities. Thirdly, it remains obscure how the gut microbiome and the BA pool interact and influence the pathogenesis of NAFLD. Lastly, it is not known how FXR mediated signaling interact with G protein-coupled bile acid receptor 1 mediated signaling. Answering these questions may lead to an improved pharmaceutical intervention for NAFLD targeting the FXR signaling pathway. Address correspondence and reprint requests to Lixin Zhu, Digestive Diseases and Nutrition Center, Department of Pediatrics, The State University of New York at Buffalo, 3435 Main Street, 422BRB, Buffalo, NY14214 (e-mail: lixinzhu@buffalo.edu); Susan S. Baker (e-mail: sbaker@upa.chob.edu) Received 7 August, 2017 Accepted 27 March, 2018 Conflict of Interest and Source of Funding: The authors declare that no conflict of interest exists. This work was supported by GEM Community of Excellence, the University at Buffalo (LZ) and the Tommy and Peter Fund, Inc., Buffalo, NY (SSB and LZ). © 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,

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Device-Related Error in Patient-Controlled Analgesia: Analysis of 82,698 Patients in a Tertiary Hospital

BACKGROUND: Patient-controlled analgesia (PCA) is one of the most popular and effective methods for managing postoperative pain. Various types of continuous infusion pumps are available for the safe and accurate administration of analgesic drugs. Here we report the causes and clinical outcomes of device-related errors in PCA. METHODS: Clinical records from January 1, 2011 to December 31, 2014 were collected by acute pain service team nurses in a 2715-bed tertiary hospital. Devices for all types of PCA, including intravenous PCA, epidural PCA, and nerve block PCA, were included for analysis. The following 4 types of infusion pumps were used during the study period: elastomeric balloon infusers, carbon dioxide-driven infusers, semielectronic disposable pumps, and electronic programmable pumps. We categorized PCA device-related errors based on the error mechanism and clinical features. RESULTS: Among 82,698 surgical patients using PCA, 610 cases (0.74%) were reported as human error, and 155 cases (0.19%) of device-related errors were noted during the 4-year study period. The most common type of device-related error was underflow, which was observed in 47 cases (30.3%). The electronic programmable pump exhibited the high incidence of errors in PCA (70 of 15,052 patients; 0.47%; 95% confidence interval, 0.36–0.59) among the 4 types of devices, and 96 of 152 (63%) patients experienced some type of adverse outcome, ranging from minor symptoms to respiratory arrest. CONCLUSIONS: The incidence of PCA device-related errors was

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Association of Neuraxial Anesthesia With Postoperative Venous Thromboembolism After Noncardiac Surgery: A Propensity-Matched Analysis of ACS-NSQIP Database

BACKGROUND: Neuraxial anesthesia improves components of the Virchow's triad (hypercoagulability, venous stasis, and endothelial injury) which are key pathogenic contributors to venous thrombosis in surgical patients. However, whether neuraxial anesthesia reduces the incidence of venous thromboembolism (VTE) remain unclear. We therefore tested the primary hypothesis that neuraxial anesthesia reduces the incidence of 30-day VTE in adults recovering from orthopedic surgery. Secondarily, we tested the hypotheses that neuraxial anesthesia reduces 30-day readmission, 30-day mortality, and the duration of postoperative hospitalization. METHODS: Inpatient orthopedic surgeries from American College of Surgeons National Surgical Quality Improvement Program database (2011–2015) in adults lasting more than 1 hour with either neuraxial or general anesthesia were included. Groups were matched 1:1 by propensity score matching for appropriate confounders. Logistic regression model was used to assess the effect of neuraxial anesthesia on 30-day VTE, 30-day mortality, and readmission, while Cox proportional hazard regression model was used to assess its effect on length of stay. RESULTS: Neuraxial anesthesia decreased odds of 30-day VTE (odds ratio 0.85, 95% confidence interval, 0.78–0.95; P = .002) corresponding to number-needed-to-treat of 500. Although there was no difference in 30-day mortality, neuraxial anesthesia reduced 30-day readmission (odds ratio 0.90, 98.3% confidence interval, 0.85–0.95; P

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Population Pharmacokinetics of Periarticular Ketorolac in Adult Patients Undergoing Total Hip or Total Knee Replacement Surgery

BACKGROUND: Ketorolac tromethamine has been used for joint infiltration by the orthopedic surgeons as a part of postoperative multimodal analgesia. The objective of this study is to investigate the pharmacokinetic properties of S (−) and R (+) enantiomers of ketorolac in adult patients undergoing total hip (THA) and knee arthroplasty (TKA). METHODS: Adult patients with normal preoperative renal function received a periarticular infiltration of 30 mg of ketorolac tromethamine along with 100 mL of 0.2% ropivacaine and 1 mg of epinephrine at the end of their THA or TKA surgery. Blood samples were taken from a venous cannula at various time points after infiltration. Pharmacokinetic modeling was performed using PMetrics 1.5.0. RESULTS: From 18 participants, 104 samples were analyzed. The peak plasma concentration for S (−) ketorolac was found to be lower than that of R (+) ketorolac, for both THA (0.19–1.22 mg/L vs 0.39–1.63 mg/L, respectively) and TKA (0.28–0.60 mg/L vs 0.48–0.88 mg/L, respectively). The clearance of the S (−) ketorolac enantiomer was higher than R (+) ketorolac (4.50 ± 2.27 vs 1.40 ± 0.694 L/h, respectively). CONCLUSIONS: Our study demonstrates that with periarticular infiltration, S (−) ketorolac was observed to have increased clearance rate and highly variable volume of distribution and lower peak plasma concentration compared to R (+) ketorolac. Accepted for publication February 28, 2018. Funding: This project was supported by research funding from the Department of Anaesthesia and Perfusion Services at the Prince Charles Hospital, Brisbane, Australia. The authors declare no conflicts of interest. Clinical trial number and registry: Australian New Zealand Clinical Trials Registry (ACTRN12613000923763). Reprints will not be available from the authors. Address correspondence to Usha Gurunathan, FANZCA, Department of Anaesthesia & Perfusion Services, The Prince Charles Hospital, Rode Rd, Chermside, QLD 4032, Australia. Address e-mail to usha.gurunathan@health.qld.gov.au. © 2018 International Anesthesia Research Society

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In-Line Filtration Reduces Postoperative Venous Peripheral Phlebitis Associated With Cannulation: A Randomized Clinical Trial

BACKGROUND: Peripheral venous cannulation is an everyday practice of care for patients undergoing anesthesia and surgery. Particles infused with intravenous fluids (eg, plastic/glass/drugs particulate) contribute to the pathogenesis of peripheral phlebitis. The aim of this study is to demonstrate the efficacy of in-line filtration in reducing the incidence of postoperative phlebitis associated with peripheral short-term vascular access. METHODS: In this controlled trial, 268 surgical patients were randomly assigned to in-line filtration and standard care (NCT03193827). The incidence of phlebitis (defined as visual infusion phlebitis [VIP] score, ≥2) within 48 hours was compared between the 2 groups, as well as the onset and severity of phlebitis and the reasons for removal of the cannula. The lifespan of venous cannulae was compared for the in-line filter and no-filter groups through a Kaplan-Meier curve. RESULTS: The incidence of phlebitis within 48 hours postoperatively was 2.2% and 26.9% (difference, 25% [95% confidence interval {CI}, 12%–36%]; odds ratio, 0.05 [0.01–0.15]), respectively, for the in-line filter and no-filter groups (P

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Integrative Pain Management Must Include Diet Considerations

No abstract available

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Essentials of Pain Medicine, 4th ed

No abstract available

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The Incidence of Transfusion-Related Acute Lung Injury at a Large, Urban Tertiary Medical Center: A Decade’s Experience

BACKGROUND: While transfusion-related acute lung injury (TRALI) remains the primary cause of transfusion-related fatalities (37%), recent reports estimate the incidence of TRALI at 0.008% per unit of plasma transfused and 0.004% per all products transfused. Because blood banks have moved toward male-predominant plasma, TRALI appears, anecdotally, to have been reduced to an extremely rare event. The purpose of this study was to estimate the current incidence of TRALI at a large, urban center known for its early and aggressive use of plasma in the setting of trauma, hemorrhagic shock, and massive transfusion. METHODS: The Blood Bank Registry of our hospital was queried for all transfused patients admitted from September 2002 through March 2013. The blood bank collected and investigated all cases of clinical acute lung injury meeting the consensus definition for TRALI, as well as potential cases for which the donor product was recalled for having a high reactivity level of human leukocyte antigen antibodies (ie, the antibodies that could cause TRALI). Clinical reactions were reviewed in conjunction with independent serological testing and classified by transfusion medicine physicians as being "probable TRALI" or of "unrelated etiology." The total number of units transfused at our facility during this time period was also obtained, allowing the incidence of TRALI to be estimated. Cases were analyzed based on demographics, outcome, blood types, observed symptoms and their duration, and type of product transfused. RESULTS: Seven cases were identified at our center for the indicated time period, with only 3 of these occurring in trauma. A total of 714,757 units of blood products were transfused between September 2002 and March 2013. The incidence of TRALI was estimated to be 1 case per 100,000 units of product for the entire study period. A broad range of patients was affected. Consistent with previous descriptions, an acute duration of symptoms (average, 1.4 days) was observed and usually resolved with supportive care. Reactions were observed predominantly in plasma products, both type specific and nontype specific. CONCLUSIONS: This study demonstrates that while TRALI still occurs, clinically meaningful cases are rare. Moreover, TRALI rates remain low despite the increasingly aggressive use of plasma and platelets in the trauma setting. Accepted for publication February 14, 2018. Funding: None. The authors declare no conflicts of interest. Reprints will not be available from the authors. Address correspondence to David E. Meyer, MD, MS, Department of Surgery, University of Texas Health Science Center at Houston, 6431 Fannin St, MSB 4.292, Houston, TX 77030. Address e-mail to david.e.meyer@uth.tmc.edu. © 2018 International Anesthesia Research Society

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Data Interpretation in Anesthesia: A Clinical Guide

No abstract available

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Geochemical signature of NORM waste in Brazilian oil and gas industry

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): G.T. De-Paula-Costa, I.C. Guerrante, J. Costa-de-Moura, F.C. Amorim
The Brazilian Nuclear Energy Agency (CNEN) is responsible for any radioactive waste storage and disposal in the country. The storage of radioactive waste is carried out in the facilities under CNEN regulation and its disposal is operated, managed and controlled by the CNEN. Oil NORM (Naturally Occurring Radioactive Materials) in this article refers to waste coming from oil exploitation. Oil NORM has called much attention during the last decades, mostly because it is not possible to determine its primary source due to the actual absence of a regulatory control mechanism. There is no efficient regulatory tool which allows determining the origin of such NORM wastes even among those facilities under regulatory control. This fact may encourage non-authorized radioactive material transportation, smuggling and terrorism. The aim of this project is to provide a geochemical signature for oil NORM waste using its naturally occurring isotopic composition to identify its origin. The here proposed method is the modeling of radioisotopes normally present in oil pipe contamination such as 228Ac, 214Bi and 214Pb analyzed by gamma spectrometry. The specific activities of elements from different decay series are plotted in a scatter diagram. This method was successfully tested with gamma spectrometry analyses of oil sludge NORM samples from four different sources obtained from Petrobras reports for the Campos Basin/Brazil.



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Comparison of experimental and calculated shielding factors for modular buildings in a radioactive fallout scenario

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Yvonne Hinrichsen, Robert Finck, Karl Östlund, Christopher Rääf, Kasper Grann Andersson
Experimentally and theoretically determined shielding factors for a common light construction dwelling type were obtained and compared. Sources of the gamma-emitting radionuclides 60Co and 137Cs were positioned around and on top of a modular building to represent homogeneous fallout. The modular building used was a standard prefabricated structure obtained from a commercial manufacturer. Four reference positions for the gamma radiation detectors were used inside the building. Theoretical dose rate calculations were performed using the Monte Carlo code MCNP6, and additional calculations were performed that compared the shielding factor for 137Cs and 134Cs. This work demonstrated the applicability of using MCNP6 for theoretical calculations of radioactive fallout scenarios. Furthermore, the work showed that the shielding effect for modular buildings is almost the same for 134Cs as for 137Cs.



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‘Omic’ technologies as a helpful tool in radioecological research

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Polina Yu. Volkova, Stanislav A. Geras'kin
This article presents a brief review of the modern 'omic' technologies, namely genomics, epigenomics, transcriptomics, proteomics, and metabolomics, as well as the examples of their possible use in radioecology. For each technology, a short description of advances, limitations, and instrumental applications is given. In addition, the review contains examples of successful use of 'omic' technologies in the assessment of biological effects of pollutants in the field conditions.



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Preparation of MnO2 coated fibers for gamma spectrometric measurements - A comparison of four practical approaches

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Michael Schubert, Martin Oberreich, Jan Scholten
The analysis of natural radium-in-water activity concentrations is for two reasons of general interest: (1) radium in natural waters may pose a problem with regard to radiation protection and (2) radium isotopes in natural waters can be used as environmental tracers in hydrological studies. A state-of-the-art method for radium extraction from (generally large) water sample volumes is radium adsorption onto MnO2 coated acrylic fibers. In our study we comparatively evaluated four methodical approaches for post-extraction preparation of the fiber to allow gamma spectrometric measurements. The methods included (1) straightforward measurement of the loose fiber, (2) compressing the fiber after mixing it with an adhesive, (3) combustion of the fiber and embedding the ash in candlewax, and (4) leaching of the fiber and embedding the resulting precipitate in candlewax. The aim of the study was to compare the advantages and disadvantages of the four preparation approaches with respect to their individual practicability. Even though the methodical fiber preparation approaches have been suggested in the literature before (as cited in this paper), results of their direct practical comparison have not been presented yet. Our study revealed that balancing practical sample preparation effort against data reproducibility suggests a measurement of the compressed fiber applying an adhesive to be the preferable approach.



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A survey of uranium levels in urine and hair of people living in a coal mining area in Yili, Xinjiang, China

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Rehemanjiang Wufuer, Wenjuan Song, Daoyong Zhang, Xiangliang Pan, Geoffrey Michael Gadd
Recent reports have drawn attention to the uranium contamination arising from coal mining activities in the Yili region of Xinjiang, China due to the mixed distribution of uranium and coal mines, and some of the coal mines being associated with a high uranium content. In this study, we have collected water samples, solid samples such as soil, mud, coal, and coal ash, and hair and urine samples from local populations in order to evaluate the uranium level in this environment and its implications for humans in this high uranium coal mining area. Our results showed that uranium concentrations were 8.71–10.91 μg L−1 in underground water, whereas lower levels of uranium occurred in river water. Among the solid samples, coal ash contained fairly high concentrations of uranium (33.1 μg g−1) due to enrichment from coal burning. In addition, uranium levels in the other solid samples were around 2.8 μg g−1 (the Earth's average background value). Uranium concentrations in hair and urine samples were 22.2–634.5 ng g−1 (mean: 156.2 ng g−1) and 8.44–761.6 ng L−1 (mean: 202.6 ng L−1), respectively, which are significantly higher than reference values reported for unexposed subjects in other areas. Therefore, these results indicate that people living in this coal mining area have been subjected to uranium exposure for long periods of time.



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The 2014 Integrated Field Exercise of the Comprehensive Nuclear-Test-Ban Treaty revisited: The case for data fusion

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Jonathan L. Burnett, Harry S. Miley, Theodore W. Bowyer, Ian M. Cameron
The International Monitoring System of the Preparatory Commission for the Comprehensive Nuclear-Test-Ban Treaty Organization (CTBTO) uses a global network of radionuclide monitoring stations to detect evidence of a nuclear explosion. The two radionuclide technologies employed—particulate and noble gas (radioxenon) detection—have applications for data fusion to improve detection of a nuclear explosion. Using the hypothetical 0.5 kT nuclear explosive test scenario of the CTBTO 2014 Integrated Field Exercise, the intrinsic relationship between particulate and noble gas signatures has been examined. This study shows that, depending upon the time of the radioxenon release, the particulate progeny can produce the more detectable signature. Thus, as both particulate and noble gas signatures are inherently coupled, the authors recommend that the sample categorization schemes should be linked.



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Submarine groundwater discharge and chemical behavior of tracers in Laizhou Bay, China

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Yan Zhang, Hailong Li, Xuejing Wang, Chaoyue Wang, Kai Xiao, Wenjing Qu
Naturally occurring radon (222Rn) and radium isotopes are widely used to trace water mixing and submarine groundwater discharge (SGD) in the coastal zones. However, their activities in groundwater are variable both spatially and temporally. Here, time series sampling of 222Rn and radium was conducted to investigate their behavior in intertidal groundwater of Laizhou Bay, China. The result shows that groundwater redox conditions have an important impact on the behavior of tracers. The activities of tracers will decrease under oxidizing conditions and increase under reducing conditions. Radon and radium mass balance models were used to evaluate the flushing time and SGD based on spatial surveys in Laizhou Bay. The flushing time is estimated to be 32.9–55.3 d with coupled models, which agrees well with the result of tidal prism model. The trace-derived SGD in the whole bay ranges from 6.1 × 108 to 9.0 × 108 m3/d and the re-circulated seawater (RSGD) ranges from 5.5 × 108 to 8.5 × 108 m3/d. The average SGD and RSGD fluxes are 22.8 and 21.1 times greater than the Yellow River discharge in April 2014, respectively. The study provides a better understanding of the dynamics of coastal groundwater and behavior of tracers in a well-studied bay system.



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Evaluation of background radiation dose contributions in the United Arab Emirates

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Braden Goddard, Emmanuel Bosc, Sarra Al Hasani, Cody Lloyd
The natural background radiation consists of three main components; cosmic, terrestrial, and skyshine. Although there are currently methods available to measure the total dose rate from background radiation, no established methods exist that allow for the measurement of each component the background radiation. This analysis consists of a unique methodology in which the dose rate contribution from each component of the natural background radiation is measured and calculated. This project evaluates the natural background dose rate in the Abu Dhabi City region from all three of these components using the developed methodology. Evaluating and understanding the different components of background radiation provides a baseline allowing for the detection, and possibly attribution, of elevated radiation levels. Measurements using a high-pressure ion chamber with different shielding configurations and two offshore measurements provided dose rate information that were attributed to the different components of the background radiation. Additional spectral information was obtained using an HPGe detector to verify and quantify the presence of terrestrial radionuclides. By evaluating the dose rates of the different shielding configurations the comic, terrestrial, and skyshine contribution in the Abu Dhabi City region were determined to be 33.0 ± 1.7, 15.7 ± 2.5, and 2.4 ± 2.1 nSv/h, respectively.



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Characterizing regional-scale temporal evolution of air dose rates after the Fukushima Daiichi Nuclear Power Plant accident

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Haruko M. Wainwright, Akiyuki Seki, Satoshi Mikami, Kimiaki Saito
In this study, we quantify the temporal changes of air dose rates in the regional scale around the Fukushima Dai-ichi Nuclear Power Plant in Japan, and predict the spatial distribution of air dose rates in the future. We first apply the Bayesian geostatistical method developed by Wainwright et al. (2017) to integrate multiscale datasets including ground-based walk and car surveys, and airborne surveys, all of which have different scales, resolutions, spatial coverage, and accuracy. This method is based on geostatistics to represent spatial heterogeneous structures, and also on Bayesian hierarchical models to integrate multiscale, multi-type datasets in a consistent manner. We apply this method to the datasets from three years: 2014 to 2016. The temporal changes among the three integrated maps enables us to characterize the spatiotemporal dynamics of radiation air dose rates. The data-driven ecological decay model is then coupled with the integrated map to predict future dose rates. Results show that the air dose rates are decreasing consistently across the region. While slower in the forested region, the decrease is particularly significant in the town area. The decontamination has contributed to significant reduction of air dose rates. By 2026, the air dose rates will continue to decrease, and the area above 3.8 μSv/h will be almost fully contained within the non-residential forested zone.



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Method for source localization proposed and applied to the October 2017 case of atmospheric dispersion of Ru-106

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Publication date: September 2018
Source:Journal of Environmental Radioactivity, Volume 189
Author(s): Jens Havskov Sørensen
An efficient numerical method for the temporal and spatial localization of an unknown point source of an atmospheric tracer is proposed. The method, which is based on inverse modelling techniques, employs available data from a network of ground-level stations on the condition that the measurements represent the plume geographically and temporally. The method, which employs a level-of-agreement approach, is applied to the October 2017 air concentration measurements of Ru-106 in Europe.



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A case of colonic varices complicated by alcoholic cirrhosis treated using balloon-occluded retrograde transvenous obliteration

Abstract

A 44-year-old man with cirrhosis arising from alcohol abuse manifested melena caused by the rupture of esophageal varices. He received endoscopic variceal ligation for the initial hemostasis, followed by endoscopic injection sclerotherapy as an additional consolidation therapy. A CT examination performed at the time of admission revealed collateral veins developing around the ascending colon, in which the feeding and draining vessels were identified as the superior mesenteric vein and the right testicular vein, respectively. Moreover, large nodular varices were observed in the ascending colon during a colonoscopy. To prevent the rupture of the colonic varices, balloon-occluded retrograde transvenous obliteration (B-RTO) was performed through the right testicular vein using a microballoon catheter. A CT examination performed 4 days after the B-RTO procedure revealed the disappearance of blood flow with thrombosis formation in both the colonic varices and the feeding vein. The varices in the ascending colon had completely disappeared when examined during a colonoscopy performed 4 months after the B-RTO procedure. B-RTO is a useful and minimally invasive procedure for the treatment of colonic varices to prevent bleeding.



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Incidence and Risk Factors for Intraoperative Seizures During Elective Craniotomy

Background: Perioperative seizures may affect 1% to 50% of patients undergoing craniotomy and adversely impact outcomes. However, data on intraoperative seizures are limited. This retrospective case-control study investigated the incidence and risk factors for intraoperative seizures during elective supratentorial craniotomy involving evoked potential monitoring. Materials and Methods: Patients aged 18 years or above undergoing elective supratentorial craniotomy with evoked potential monitoring who experienced intraoperative seizures at our institution between December 2008 and March 2014 were compared with a control group generated using a random number generator. Six controls were used for each case from among the patients who underwent elective supratentorial craniotomy during the same calendar year. Multivariate analysis was conducted using logistic regression to identify the risk factors for intraoperative seizures. Results: Among the 1916 patients who met the inclusion criteria, 45 (2.3%) had intraoperative seizures. The majority of seizures occurred during burr-hole placement or craniotomy, before lesion manipulation. Timing of seizures relative to motor evoked potential runs and stimulus intensity was variable. Significant risk factors for intraoperative seizures were seizure history (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.07-4.46; P=0.03), diagnosis of brain tumor (OR, 2.41; 95% CI, 1.16-4.19; P=0.02), and temporal craniotomy (OR, 5.18; 95% CI, 2.03-13.25; P=0.001). Intraoperative prophylactic use of phenytoin/fosphenytoin and levetiracetam was protective against seizure (phenytoin/fosphenytoin: OR, 0.12; 95% CI, 0.04-0.35; P

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